Pilon骨折延期手术治疗效果及术后感染病原菌分析  

Effect of delayed surgery for Pilon fracture and analysis of postoperative infection pathogens

作　　者：林文琛[1] 林伟东[1] 王育新[1] 许耀明[1] 王守东[1] 杨滨[2] 

机构地区：[1]石狮市医院骨科,福建石狮362700 [2]福建医科大学附属第一医院检验科,福建福州350005

出　　处：《中华医院感染学杂志》2017年第11期2555-2557,2561,共4页Chinese Journal of Nosocomiology

基　　金：福建省卫生厅青年基金资助项目(2013-2-39)

摘　　要：目的比较Pilon骨折延期手术治疗和传统早期手术治疗效果,并分析Pilon骨折延期手术术后感染病原菌。方法分析2011年1月-2016年2月医院收治278例Pilon骨折患者的临床资料,将延期手术治疗137例患者为观察组,给予早期切开复位内固定术141例患者为对照组。结果两组患者经不同术式治疗后,观察组患者优良率89.1%,高于对照组70.9%,差异有统计学意义(P<0.05);观察组患者术后并发症发生率24.8%,低于对照组41.8%,差异有统计学意义(P<0.05);观察组患者术后共分离出13株病原菌,革兰阳性菌9株占69.23%,革兰阴性菌4株占30.77%,观察组患者术后感染病原菌主要以金黄色葡萄球菌感染为主。结论分步延期手术较内固定术治疗效果较好,并发症发生率较低,术中给予抗金黄色葡萄球菌的药物可以有效减少术后感染。OBJECTIVE To compare the effects of delayed surgical treatment and traditional early surgical treatment for Pilon fracture and analyzed postoperative infection pathogens after Pilon fracture delayed surgery.METHODS The clinical data of 278 cases of patients with Pilon fracture in our hospital from Jan.2013 to Feb.2016 were ana lyzed.The 137 cases of patients treated with delayed surgery were set as observation group,and 141 cases treated with early open reduction and internal fixation were set as control group.RESULTS After treated with different kinds of surgeries,the excellent rate of observation group was 89.05 %,which was significantly higher than 70.9% of control group（P〈0.05）.The postoperative complication rate of observation group was 24.82%,which was significantly lower than 41.8% of control group （P〈0.05）.A total of 13 strains of pathogenic bacteria were isolated from observation group,including 9 strains of gram positive bacteria and 4 strains of gram-negative bacteria,accounting for 69.23% and 30.77%.The pathogens of postoperative infection of observation group were mainly Staphylococcus aureus.CONCLUSION Compared with internal fixation,the effect of delayed surgical treatment is better,the complication rate is lower,and the drugs which are resistant to S.aureus can reduce the incidence of postoperative infection.

关 键 词：PILON骨折 延期手术 骨折内固定术 治疗效果 感染 

分 类 号：R619.3[医药卫生—外科学]